| Name Of the Firm : | Jai Santoshi Maa Medical & General Store, |
| Zone : | S/Z |
| Range : | PKD |
| Police Station : | |
| Address : | At-Kantragada, p no- 395, k no- 10 |
| RP Name : | Bhajaram Rout Regd.No-5652/OPC |
| Registration Number : | Regd.No-5652/OPC |
| Competent Person : | |
| Qualification : | |
| Name of the Proprietor : | Jami Bhaskar Rao (Prop) |
| R : | 17 |
| RC : | 18 |
| RX : | 9 |
| RR : | |
| RRC : | |
| W : | |
| WC : | |
| WX : | |
| Date of Issue : | 1992 |
| Date of Expiry : | 31.12.16 |
| Remarks : |